U.S. patent application number 12/127524 was filed with the patent office on 2008-11-27 for irradiation treatment apparatus and method.
Invention is credited to Azriel Kadim, Michael Marash.
Application Number | 20080292053 12/127524 |
Document ID | / |
Family ID | 39769608 |
Filed Date | 2008-11-27 |
United States Patent
Application |
20080292053 |
Kind Code |
A1 |
Marash; Michael ; et
al. |
November 27, 2008 |
IRRADIATION TREATMENT APPARATUS AND METHOD
Abstract
The present disclosure provides an irradiation treatment
apparatus having a generally vertical patient support surface, a
patient securing mechanism arranged to secure a patient in a fixed
relation to the patient support surface; a rotation platform
secured at one end of the patient support surface and arranged to
rotate the patient support surface about a generally vertical axis
and optionally translate the patient support surface at least
partially about a plane generally orthogonal to the generally
vertical axis; an imager exhibiting a first mode in which the
imager occlude radiation from a fixed beam irradiation source and a
second mode in which the imager enables irradiation from the fixed
beam irradiation source; and a vertical translation mechanism in
communication with the patient support surface and arranged to
translate the patient support surface along the generally vertical
axis from a loading position to an irradiation position.
Inventors: |
Marash; Michael; (Rishon
Le'tzion, IL) ; Kadim; Azriel; (Elkana, IL) |
Correspondence
Address: |
PEPPER HAMILTON LLP
ONE MELLON CENTER, 50TH FLOOR, 500 GRANT STREET
PITTSBURGH
PA
15219
US
|
Family ID: |
39769608 |
Appl. No.: |
12/127524 |
Filed: |
May 27, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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60939929 |
May 24, 2007 |
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61028519 |
Feb 14, 2008 |
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60939923 |
May 24, 2007 |
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Current U.S.
Class: |
378/65 ;
250/492.3 |
Current CPC
Class: |
A61B 6/0421 20130101;
A61B 6/4014 20130101; A61N 2005/1087 20130101; A61B 6/0478
20130101; A61B 6/547 20130101; A61N 5/1064 20130101; A61B 6/0487
20200801; A61B 6/032 20130101; A61B 6/04 20130101; A61N 5/1049
20130101; A61N 2005/1061 20130101; A61N 5/1078 20130101; A61B
6/4266 20130101 |
Class at
Publication: |
378/65 ;
250/492.3 |
International
Class: |
A61N 5/10 20060101
A61N005/10; A61N 5/00 20060101 A61N005/00 |
Claims
1. An irradiation treatment apparatus comprising: a patient support
surface; a rotation mechanism, a patient securing mechanism
arranged to secure a patient in a fixed relation to said patient
support surface; a platform in communication with said patient
support surface and said rotation mechanism and arranged to rotate
said patient support surface about a generally vertical axis; an
imager exhibiting a first mode in which the imager occludes
radiation from a fixed beam irradiation source and a second mode in
which the imager enables irradiation from the fixed beam
irradiation source; and a vertical translation mechanism in
communication with said patient support surface and arranged to
translate said patient support surface along said generally
vertical axis from a loading position to an irradiation
position.
2. An irradiation treatment apparatus according to claim 1, wherein
said imager is translatable vertically between an imaging position
being said first mode and a neutral position being said second
mode.
3. An irradiation treatment apparatus according to claim 1, wherein
said imager exhibits a window, said first mode being when said
window is closed and said second mode being when said window is
open.
4. An irradiation treatment apparatus according to claim 3, further
comprising a control unit in communication with said imager, said
control unit operative to: set said imager to said first mode;
translate said patient support surface vertically through said
imager via said vertical translation mechanism, and operate said
imager to thereby image a section of the patient.
5. An irradiation treatment apparatus according to claim 1, wherein
said imager exhibits a radially shiftable section, said first mode
being when said radially shiftable section is shifted to enable a
360 degree x-ray image, and said second mode being when said
radially shiftable section is shifted to enable a less than 360
degree x-ray image.
6. An irradiation treatment apparatus according to claim 5, further
comprising a control unit in communication with said imagery said
control unit operative to: set said imager to said first mode;
translate said patient support surface vertically through said
imager via said vertical translation mechanism, and operate said
imager to thereby image a section of the patient.
7. An irradiation treatment apparatus according to claim 3, wherein
said imager in said second mode is operative to perform
intra-treatment imaging.
8. An irradiation treatment apparatus according claim 1, wherein
said imager is arranged to perform computerized tomography.
9. An irradiation treatment apparatus according to claim 1, wherein
said vertical translation mechanism is coupled to said platform
thereby in said communication with said patient support
surface.
10. An irradiation treatment apparatus according to claim 1,
further comprising a horizontal translation mechanism coupled to
said platform, said horizontal translation mechanism operative to
translate said patient support surface along a pair of orthogonal
axes perpendicular to said generally vertical axis.
11. An irradiation treatment apparatus according to claim 1,
wherein said irradiation position aligns a target tissue of the
secured patient with a beam of radiation ultimately exiting a fixed
beam irradiation source.
12. An irradiation treatment apparatus according to claim 1,
further comprising an imager translation mechanism coupled to said
imager and operative to position said imager vertically over a
continuous range of positions in relation to said patient support
surface loading position.
13. An irradiation treatment apparatus according to claim 1, father
comprising an imager translation mechanism in communication with
said imager operative to position said imager vertically at an
imaging position being said first mode and a neutral position being
said second mode, said imaging position arranged to image tissue
intersecting an treatment irradiation beam ultimately exiting a
fixed beam irradiation source.
14. An irradiation treatment apparatus according to claim 12,
further comprising a control unit in communication with said imager
translation mechanism, said imager and said vertical translation
mechanism, said control unit operative to: translate said imager
vertically via said imager translation mechanism to said first
mode; translate said patient support surface vertically through
said imager via said vertical translation mechanism, and operate
said imager to thereby image a section of the patient.
15. An irradiation treatment apparatus according to claim 14,
wherein said imaging of said section at least partially provides
for treatment planning.
16. An irradiation treatment apparatus according to claim 1,
further comprising a fixed beam radiation source.
17. An irradiation treatment apparatus according to claim 1,
wherein said patient support surface is generally vertical.
18. An irradiation treatment apparatus according to claim 17,
wherein said generally vertical patient support surface exhibits a
chair mode in which the spine of the patient is generally secured
vertically by said generally vertical patient support surface.
19. A method comprising: securing a patient to a patient support
surface; vertically translating the secured patient so as to
approximately align a target tissue of the secured patient with an
treatment irradiation beam ultimately exiting a fixed beam
irradiation source; rotating the secured patient about a generally
vertical axis so as to approximately present the target tissue to
the treatment irradiation beam ultimately exiting the fixed beam
irradiation source at a first desired angle; setting an imager to a
first of two modes in which the imager occludes radiation from a
fixed beam irradiation source; imaging, via said imager in said
first mode, said target tissue aligned with the treatment
irradiation beam ultimately exiting the fixed beam irradiation
source; setting said imager to a second of two modes in which the
imager does not occlude radiation from the fixed beam irradiation
source; and irradiating the target tissue from said fixed beam
irradiation source at said first desired angle.
20. A method according to claim 19, further comprising subsequent
to said imaging said target tissue, at least one of: finely
vertically translating, responsive to said imaging, the secured
patient so as to align the target tissue of the secured patient
with the treatment irradiation beam ultimately exiting a fixed beam
irradiation source at said first desired angle; and finely rotating
the secured patient about the generally vertical axis, responsive
to said imaging, so as to present the target tissue to the
treatment irradiation beam ultimately exiting the fixed beam
irradiation source at said first desired angle.
21. A method according to claim 19, further comprising prior to
said irradiating, translating a source of irradiation along a
longitudinal axis of the ultimate radiation beam, so as to achieve
a desired distance between the fixed beam irradiation source and
said target tissue.
22. A method according to claim 19, wherein the imager is arranged
to perform computerized tomography.
23. A method according to claim 19, wherein the imager is
translatable over a range of positions, said first mode being an
imaging position.
24. A method according claim 19, wherein said imager is
translatable between said neutral position and said imaging
position.
25. A method according to claim 19, further comprising imaging said
target tissue during said irradiating with said imager in said
second mode.
26. A method according claim 19, wherein said securing the patient
to a patient support surface is in one of a standing and a sitting
position.
27. A method according to claim 19, further comprising subsequent
to said irradiating at said first desired angle: rotating about a
generally vertical axis, and translating about a plane orthogonal
to said generally vertical axis, the secured patient so as to
approximately present the target tissue to the treatment
irradiation beam ultimately exiting the fixed beam irradiation
source at a second desired angle; setting the imager to said first
mode; imaging, via said imager, said target tissue aligned with the
treatment irradiation beam ultimately exiting the fixed beam
irradiation source; setting said imager to said second mode; and
irradiating the target tissue from said fixed beam irradiation
source at said second desired angle.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority from U.S. Provisional
Patent Application Ser. No. 60/939,923 filed May 24, 2007, entitled
"Teletherapy Positioning and Validation," and U.S. Provisional
Patent Application Ser. No. 61/028,519, bearing the present title,
filed Feb. 14, 2008. This application is also related to U.S.
patent application Ser. No. 12/127,391, entitled "Method and
Apparatus for Teletherapy Positioning and Validation," filed on May
27, 2008. Each of the above applications is incorporated herein by
reference.
TECHNICAL FIELD
[0002] The present disclosure relates generally to the field of
teletherapy and in particular to a system and method for
positioning and validation of a patient before a fixed beam
irradiation source.
BACKGROUND
[0003] Teletherapy generally employs an irradiation source disposed
at a distance from the body to be treated. X-rays and electron
beams have been used in teletherapy to treat various cancers.
However, X-rays and electron beams exhibit an energy transfer
characteristic approaching an exponential attenuation function and
are therefore not optimal for treating deeply embedded growths or
target areas. Recently, the use of heavy particles particularly
hadrons, in teletherapy has found increasing acceptance, in part
because of the ability of heavy particles to penetrate to a
specific depth without appreciably harming intervening tissue. In
particular, the energy transfer characteristic of hadrons exhibits
an inversed depth profile with a Bragg peak at a location where the
hadrons deposit most of their energy, which is approximately at the
end of the hadrons' path. As a result of this hadron energy
transfer characteristic, increased energy can be directed at or
deposited in an embedded growth as compared to X-rays and electron
beams. Also, less damage to healthy intervening tissue results when
hadron beams are used to treat deep-seated tumors or diseased
target tissue.
[0004] It should be appreciated that the term "hadrons" can refer
to a variety of particles, including protons and other ions that
are used in therapy. While this document describes treatment as
being accomplished with protons, this is not meant to be limiting
in any way and other types of hadrons and ions can be included in
such discussion where appropriate.
[0005] Typically, in a therapy system, the charged protons or ions
are focused into narrow, intensity-modulated, scanned pencil beams
of variable penetration depth. In this way, the dose profile can be
matched to the target volume. In order to ensure complete
irradiation of the target growth, a plurality of beams arriving at
the embedded growth from several different directions can be used.
The volume in which the plurality of beams intersects, whether the
beams are provided sequentially or simultaneously, is often
referred to as an isocenter. To improve the biological
effectiveness of the treatment, the isocenter is collocated with
the target growth to deliver the maximum treatment dose to the
target volume and to spare the surrounding tissue.
[0006] Present teletherapy systems use a gantry apparatus carrying
a beam generating and delivery system. The gantry is a motorized or
powered apparatus for moving the massive particle delivery system
around a patient who is typically immobilized on a treatment table.
Since the beam generating and delivery system is large and
extremely heavy, such gantry systems are prohibitively expensive,
limiting the number of available proton therapy centers that can
provide services to patients. Furthermore, the spatial range of
such gantry-driven systems is limited due to mechanical
constraints. Movement of the beam generating and delivery system
from location to location in order to effect the delivery of the
plurality of beams leads to an offset in the isocenter which must
be carefully adjusted prior to beam delivery. One example of the
above-described treatment systems is illustrated in U.S. Pat. No.
6,769,806 to Moyers.
[0007] For example, World Intellectual Property Organization
Publication WO 2007/012649 published Feb. 1, 2007 to Siemens
Aktiengescllshaft, is directed to a device for obtaining image data
for planning a radiation therapy, comprising a computerized
tomography (CT) gantry and a patient positioning unit. The CT
gantry is arranged in a moveable fashion in such a way that imaging
for the purposes of radiation therapy can be carried out in this
body position of the patient. The need for a freely moveable CT
gantry adds to cost, as a CT of the quality necessary for preferred
imaging can weigh 2 metric tons or more.
[0008] Imagers have been available for use in the context of
patient treatment, for example as appear in U.S. Pat. No. 6,949,941
issued Sep. 6, 2005 to Gregerson et al., entitled "Breakable Gantry
Apparatus for Multidimensional X-ray Based Imaging."
[0009] Additionally, the prior art requires separate arrangements
for treatment planning and irradiation. Such a need for a plurality
of arrangements further adds to the cost of the system and
diminishes its practical availability.
[0010] There is thus a need for an improved teletherapy apparatus
that overcomes some or all of the above limitations.
SUMMARY
[0011] In view of the discussion provided above and other
considerations, the present disclosure provides methods and
apparatus to overcome some or all of the disadvantages of prior and
present teletherapy systems and methods. Other new and useful
advantages of the present methods and apparatus will also be
described herein and can be appreciated by those skilled in the
art.
[0012] In one embodiment, this is provided by an irradiation
treatment apparatus comprising a patient securing means arranged to
secure a patient in a generally vertical position to a patient
support surface. The patient support surface is connected at one
end to a rotatable platform, arranged to rotate the patient support
surface about a generally vertical axis thereof and to optionally
translate the patient support surface along at least a portion of a
plane perpendicular to the axis of rotation. The patient support
surface is further translatable vertically, generally along the
axis of rotation and arranged generally before a fixed beam
irradiation source.
[0013] In one embodiment, an imager, preferably a computerized
tomography (CT) imager, exhibiting two modes of operation is
provided. In a first mode, the imager occludes the fixed beam
irradiation source, and in a second mode the imager enables
irradiation from the fixed beam irradiation source.
[0014] In one particular embodiment, the imager is translatable
vertically between the first and second modes. In another
particular embodiment the imager exhibits a radially shiftable
section, with the first mode representative of the imager being a
substantially closed ring and the second mode representative of the
imager with section radially shifted.
[0015] In yet another particular embodiment the imager is provided
with a window for passage of the treatment irradiation beam with
the first mode representative of the window being closed and the
second mode representative of the window being open.
[0016] Preferably, the imager in the first mode provides fine
resolution images sufficient for treatment planning. In certain
embodiments the second mode provides sufficient definition for
inter-treatment verification and intra-treatment verification.
[0017] In one embodiment the patient is loaded onto the patient
support surface, platform, or generally, member, in a loading
position, and the patient support member is translated vertically
to approximately align a target tissue with a fixed beam
irradiation source. The patient support surface is further
translated horizontally and/or rotated so as to approximately align
the target tissue with the ultimate path of a fixed beam of
irradiation at the desired angle to treat a target volume of
diseased tissue.
[0018] It is to be understood that the term fixed beam irradiation
source, as used in this document, does not exclude scanning and
scattering technologies, which are sourced from a fixed location
charged hadron source with post beam generation scanning or
scattering functionality. It is also to be understood that the term
fixed beam irradiation source, as used in this document, is not
limited to a single fixed beam irradiation source, and multiple
fixed beams, which are independently controlled or joint
controlled, may be supplied without exceeding the scope of the
invention.
[0019] Additional features and advantages of the invention will
become apparent from the following drawings and description.
BRIEF DESCRIPTION OF THE DRAWINGS
[0020] For a better understanding of the invention and to show how
the same may be carried into effect, reference will now be made,
purely by way of example, to the accompanying drawings in which
numerals designate corresponding elements or sections
throughout.
[0021] FIG. 1 illustrates an exemplary embodiment of an irradiation
treatment apparatus and treatment;
[0022] FIG. 2A illustrates en exemplary embodiment of a first base
rail platform of the irradiation treatment apparatus of FIG. 1;
[0023] FIG. 2B illustrates an exemplary cut 2B of the first base
rail platform of FIG. 2A;
[0024] FIG. 3A illustrates an exemplary embodiment of a
translatable second base rail platform of the irradiation treatment
apparatus of FIG. 1;
[0025] FIG. 3B illustrates en exemplary cut 313 of the translatable
second base rail platform of FIG. 3A;
[0026] FIG. 3C illustrates an exemplary cut 3C of the translatable
second base rail platform of FIG. 3A;
[0027] FIG. 4A illustrates an exemplary, partially cut away, top
view of a base support for the patient platform of FIG. 1,
including a mechanism for translating an imager and a mechanism for
rotating a patient support surface;
[0028] FIG. 4B illustrates an exemplary cut 4B of the base support
of FIG. 4A;
[0029] FIG. 4B illustrates an exemplary cut 4 of the base support
of FIG. 4A;
[0030] FIG. 5A illustrates an exemplary, partially cut away, top
view of a patient platform including a scissor mechanism in the
closed position for translating the patient platform
vertically;
[0031] FIG. 5B illustrates an exemplary side view of scissor
mechanism 420, in a partially opened position, with patient
platform 70 at a top end thereof;
[0032] FIG. 5C illustrates an exemplary high level perspective
bottom view drawing of patient platform 70, including a scissor
mechanism in a closed position;
[0033] FIG. 6 illustrates an exemplary high level side view of the
irradiation treatment apparatus and treatment arrangement of FIG. 1
with a seated patient secured in a generally vertical position
against a patient support surface, with the imager in a neutral
position;
[0034] FIG. 7 illustrates an exemplary high level side view of the
irradiation treatment apparatus and treatment arrangement of FIG. 1
with a standing patient secured in a generally vertical position
against a patient support surface, with the imager in a an imaging
position;
[0035] FIG. 8 illustrates an exemplary high level side view of an
irradiation treatment apparatus and treatment arrangement in which
the imager exhibits a window which when open allows for entry of
the fixed beam irradiation source;
[0036] FIG. 9A illustrates an exemplary high level top view of an
imager exhibiting a radially shiftable section;
[0037] FIG. 9B illustrates an exemplary high level side view of an
irradiation treatment apparatus and treatment arrangement in which
the imager the imager of FIG. 9A has shifted the radially shiftable
section to allow for entry of the fixed beam irradiation
source;
[0038] FIG. 10 illustrates an exemplary perspective drawing of an
embodiment of a patient support surface;
[0039] FIG. 11 illustrates an exemplary high level flow chart of an
embodiment of a method of irradiation;
[0040] FIG. 12 illustrates an exemplary high level flow chart of an
embodiment of a method of treatment planning; and
[0041] FIG. 13 illustrates an exemplary high level frontal view
drawing of a second embodiment of an irradiation treatment
apparatus and treatment arrangement.
DETAILED DESCRIPTION
[0042] Some or all of the present embodiments provide and enable an
irradiation treatment apparatus which preferably further provides
treatment planning.
[0043] Where a patient is referred to, the patient is preferably a
live human, but can also be an animal, other suitable organs, or
target for application of the present teletherapy thereto.
[0044] The target tissue is delineated from adjacent non-target
tissue; a planned target volume (PTV) is determined; and a
plurality of beam angles and the preferred distance of the
delineated target tissue from the treatment irradiation beam source
for each of the plurality of angles is determined.
[0045] It is also to be understood that fixed beam irradiation may
include scanning and scattering technologies, which are sourced
from a fixed location charged hadron source with post beam
generation scanning or scattering functionality. In addition, fixed
beam irradiation is not limited to that from a single fixed beam
irradiation source, but can include multiple fixed beams which are
independently controlled or jointly controlled.
[0046] In one embodiment, the irradiation treatment apparatus
comprises a patient securing means arranged to secure a patient in
a generally vertical position to a patient support surface. The
patient support surface is connected at one end to a rotatable and
translatable platform, arranged to rotate the patient support
surface about a generally vertical axis thereof and to translate
the patient support surface along a plane perpendicular to the axis
of rotation. The patient support surface is further translatable
vertically, generally along the axis of rotation. An imager,
preferably a computerized tomography imager exhibiting fine
resolution, is provided and arranged to be translatable vertically.
In one further embodiment, the imager is translatable between a
first neutral position and a second imaging position. In another
embodiment the imager is translatable over a range of positions. In
yet another embodiment the imager is fixed, and is arranged to
change from a mode in which the treatment irradiation beam is
occluded from the patient and a mode in which the treatment
irradiation beam is arranged to impact the patient.
[0047] The patient is loaded onto the patient support surface in a
loading position, and the patient support surface it translated
vertically to approximately align a target tissue with a fixed beam
irradiation source. The patient support surface is further rotated,
and optionally translated horizontally, so as to approximately
align the target tissue with the ultimate beam of irradiation at
the desired angle.
[0048] Optionally, and advantageously, the irradiation treatment
apparatus can in one embodiment be further utilized for treatment
planning, particularly in an embodiment in which the imager is of
sufficiently fine resolution.
[0049] In the event that multiple treatment angles are prescribed
the above is repeated for each treatment angle, preferably with
imaging after each translation or rotation of the patient support
surface.
[0050] In order to accomplish teletherapy in accordance with an
embodiment of the subject invention, a fixed beam irradiation
source is supplied in a treatment room. In one embodiment the fixed
beam irradiation source is arranged to controllably output a
generally horizontal beam, and in another embodiment the fixed beam
irradiation source is arranged to controllably output a generally
angled beam up to 45.degree. from horizontal. It is understood that
unless specifically limited by the particular instance, where
angles and orientations are referred to herein, such are only
provided by way of example, and other angles or orientations can be
included within the scope of the present discussion.
[0051] In yet another embodiment multiple fixed beams, which are
independently controlled or joint controlled, may be supplied
without exceeding the scope of the invention. The fixed beam
irradiation source may further exhibit post scanning or scattering
functionality without exceeding the scope of the invention.
Preferably, the fixed beam irradiation source exhibits an exit
nozzle, which may be telescoped or otherwise translated to a
prescribed distance from the target tissue.
[0052] As stated earlier and elsewhere it is to be appreciated that
the invention is not limited in its application to the details of
construction and the arrangement of the components set forth in the
following description or illustrated in the drawings. The invention
also comprehends other embodiments and can be practiced or carried
out in various ways.
[0053] FIG. 1 illustrates an exemplary high level frontal view of a
first embodiment of an irradiation treatment apparatus and
treatment arrangement. The apparatus includes a fixed beam
irradiation source 10 and an irradiation treatment apparatus 5 and
a control unit 15. Irradiation treatment apparatus 5 includes a
first base rail platform 20, a translatable second base rail
platform 30, a translatable platform 40 and an imager 50.
Translatable platform 40 comprises: a base support 55, an imager
vertical translation mechanism 60, a platform vertical translation
mechanism 65, a patient platform 70 and a patient support surface
or member 90. Patient platform 70 is rotatable around an axis 80
and is vertically translatable by vertical translation mechanism 65
in relation to base support 55. Patient support surface 90 is
arranged to secure a patient in a generally vertical position, and
is secured at one end to patient platform 70. Imager 50 is
vertically translatable by imager vertical translation mechanism
60. The translation mechanisms of translatable second base rail
platform 30, translatable platform 40 and patient support surface
70 will be described further in relation to FIGS. 2, 3 and 5,
respectively. Platform vertical translation mechanism 60 will be
described further relation to FIG. 4.
[0054] Imager 50 is illustrated as a circular CT imager, however
this is not meant to be limiting in any way. In another embodiment
imager 50 is selected from among an ultrasound imager, a CT imager,
a magnet resonance imager, an x-ray imager, a fluoroscope, a
positron emission tomography imager and a single photon emission
computed tomography imager, and may comprise a combination of
imagers without exceeding the scope of the invention.
[0055] In operation, patient platform 70 is placed in a loading
position by platform vertical translation mechanism 65, and the
patient is loaded and secured to patient support surface 90.
Patient platform 70 is then translated by platform vertical
translation mechanism 65, in relation to base support 55, to
approximately align a target tissue with fixed beam irradiation
source 10. Patient platform 70 is further translated horizontally,
if required, by translatable second base rail platform 30 and
translatable platform 40, and rotated around axis 80 so as to
approximately align the target tissue of the patient secured to
patient support surface 90 with the ultimate beam of irradiation
exiting fixed beam irradiation source 10 at the desired angle.
[0056] Imager 50 is translated vertically to the imaging position
by imager vertical translation mechanism 60, and the target tissue
is imaged. Again it is pointed out that when referring to vertical
direction or orientation, it is intended to include substantially
vertical direction or orientation. The same generalization applies
to discussion of horizontal or other, directions and
orientations.
[0057] In the imaging position, imager 50 occludes the ultimate
beam from fixed beam irradiation source 10. Responsive to the
image, fine tuning of the vertical translation, rotation and
horizontal translation of patient platform 70, if required, is
performed. Imager 50 is then translated vertically by imager
vertical translation mechanism 60 to a neutral position in which
imager 50 does not occlude the ultimate beam from fixed beam
irradiation source 10. Optionally, a nozzle or aperture of fixed
beam irradiation source 10 is translated generally along the
ultimate irradiation beam axis, so that the nozzle or aperture is
at a predetermined distance from the target tissue, and irradiation
from the fixed beam irradiation source is performed without further
movement of the patient.
[0058] In the event that multiple treatment angles are prescribed
the above is optionally repeated for each treatment angle, further
optionally with imaging after each rotation, or optional
translation, of patient platform 70.
[0059] Irradiation treatment apparatus 5 is being described in an
embodiment in which patient platform 70 may be translated along a
plane, however this is not meant to be limiting in any way. In
another embodiment, patient platform 70 is only partially
translatable about a plane, with the balance of the translation
effective supplied by the articulation of fixed beam irradiation
source 10 along the axis of irradiation.
[0060] In a preferred embodiment imager 50 and all translation and
rotation mechanisms are responsive to control unit 15.
[0061] FIG. 2A illustrates an exemplary high level top view of
first base rail platform 20 of the irradiation treatment apparatus
5 of FIG. 1, including a plurality of rails 110, a plurality of
extended screws 120, a tooth gear 125, a pair of chains 130, a
tooth gear 135 and a motor 140. Motor 140 is arranged to move
chains 130 horizontally by engaging with tooth gear 135 connected
to the shaft of motor 140. Each of extended screws 120 are arranged
to engage a respective chain 130 by the respective tooth gear 125
arranged at an end of the respective extended screw 120. FIG. 2B
illustrates cut 2B of first base rail platform 20 of FIG. 2A.
[0062] In operation, motor 140 turns tooth gear 135 which interacts
with chains 130, thereby moving chains 130. Chains 130 interact
with a respective tooth gear 125, thereby turning the respective
extended screw 120. Extended screws 120 represent the translation
mechanism of translatable second base rail platform 30, as will be
described further in FIG. 3B.
[0063] FIG. 3A illustrates an exemplary high level top view drawing
of translatable second base rail platform 30 of irradiation
treatment apparatus 5 of FIG. 1, including a plurality of
strengthening members 205, a plurality of wheels 210, a plurality
of rails 230, a plurality of extended screws 240 each exhibiting a
tooth gear 245, a pair of chains 250, and a motor 260 exhibiting a
tooth gear 255 connected to the shaft thereof. Tooth gear 255 and
tooth gears 245 each engage chain 250 at respective locations.
[0064] In operation, motor 260 turns tooth gears 255 which
interacts with chain 250, thereby moving chain 250. Moving chain
250 interacts with each tooth gear 245, thereby turning extended
screws 240. Extended screws 240 represent the translation mechanism
of translatable platform 40, as will be described further in
relation to FIG. 3C. Wheels 210 run along rails 110 of first base
rail platform 20 of FIG. 2.
[0065] FIG. 3B illustrates an exemplary cut 313 of translatable
second base rail platform 30 of FIG. 3A. Extended screws 120 of
FIG. 2 are placed through a respective nut 220. In operation,
extended screws 120 are rotated as described above in relation to
FIG. 2, thereby translating translatable second base rail platform
30 along rails 110 of first base rail platform 20 of FIG. 2, with
wheels 210 engaging rails 110.
[0066] FIG. 3C illustrates an exemplary cut 3C of translatable
second base rail platform 30 of FIG. 3A. Residing on rails 230 are
wheels 210 of translatable platform 40 of FIG. 1, as will be
described further in FIGS. 4A, 4B. Extended screws 240 of FIG. 3A
are placed through a respective nut 270 of platform 40, as will be
further in FIGS. 4A, 4B. In operation, extended screws 240 are
rotated as described above, thereby translating translatable
platform 40 of FIG. 1 along the rails of second base rail platform
200 of FIG. 3A, with wheels of translatable platform 40 running
along rails 230.
[0067] In some embodiments, the longitudinal axis of rails 230 are
arranged to be orthogonal to the longitudinal axis of rails 110
thereby enabling translation of patient platform 70 about a
horizontal plane.
[0068] FIG. 4A illustrates an exemplary high level, partially cut
away, top view of base support 55 of irradiation treatment
apparatus 5 of FIG. 1, including a hole 305, a plurality of wheels
310, a plurality of channels 320 each enclosing a respective
extended screw 325, a chain 340; a plurality of pulleys 345, a
motor 350, a strengthening ring 360, a plurality of tooth gears 365
and a motor 370. A centering pin of a base for patient support
surface 70 of FIG. 1, as will be described further in FIG. 5A, is
placed in hole 305. Wheels 310 run along rails 230 of translatable
second base rail platform 30 of FIG. 3A, as described above in
relation to FIG. 3C. Extended screws 325 of respective channels 320
each exhibit a tooth gear 330, as will be described further in
relation to FIG. 4B, which are arranged to engage chain 340. Chain
340 is arranged to run substantially around the perimeter of base
support 55 by pulleys 345, and engages a tooth gear (not shown)
connected to the shaft of motor 350.
[0069] In operation, motor 350 interacts with chain 340 thereby
moving chain 340, and moving chain 340 interacts with tooth gears
330 connected to extended screws 325, as described further in
relation to FIG. 4B, thereby turning extended screws 325. Extended
screws 325 interact with one of fixed slots on imager 50 (not
shown), or nuts attached thereto, thereby translating imager 50
vertically.
[0070] Motor 370, which exhibits a tooth gear 365 attached to the
shaft thereof, turns a large tooth gear 470, which will be
explained further in relation to FIG. 5A, by meshing through an
intermediary tooth gear 365. Patient platform 70 of FIG. 1 is
connected to large tooth gear 360, as will be described further in
relation to FIG. 5A. Thus, in operation motor 370 rotates patient
platform 70 by turning large tooth gear 360.
[0071] FIG. 4B illustrates an exemplary cut 413 of base support 55
showing tooth gears 330 of extended screws 325 and FIG. 4C
illustrates cut 4C of base support 55. Extended screws 240 of FIG.
3A are arranged to pass through a respective nut 380. In operation,
as described above in relation to FIG. 3C, extended screws 240 are
rotated as described in FIG. 3A, thereby translating platform base
55 along the rails of second base rail platform 30 of FIG. 3A, with
wheels 310 running along rails 230 of second base rail platform
30.
[0072] FIG. 5A illustrates an exemplary high level, partially cut
away, top view of patient platform 70, including a scissor
mechanism in the closed position, for translating patient platform
70 vertically. In some embodiments, patient platform 70 includes a
plurality of connecting members 410, a scissor mechanism 420, a
pair of beams 430, a plurality of runners 435, a pair of channels
440, a pair of toothed linear members 450, a tooth gear 455, a
motor 460 and a large tooth gear 470. Connecting members 410 are
arranged to connect patient platform 70 to large tooth gear 360 of
base support 55 of FIG. 4A and a centering pin 490 of base 400
(shown in FIG. 5B) is placed in hole 305 of base support 55,
thereby enabling rotation of patient platform 70 of FIG. 1 when
large tooth gear 470 is turned as described above in relation to
FIG. 4A. Scissor mechanism 420 is connected at and thereof to beams
430, beams 430 being connected at their ends to runners 435, which
are placed in channels 440. Each beam 430 is also connected to a
toothed linear member 450. Toothed linear members 450 are arranged
to mesh with tooth gear 455. Motor 460 exhibits a tooth gear (not
shown) arranged to mesh with a tooth gear on the shaft of tooth
gear 455. Tooth gear 455 is arranged to mesh with toothed linear
member 450.
[0073] In operation, motor 460 rotates tooth gear 455 which
translates toothed linear members 450 in unison. As toothed linear
members 450 are translated, beams 430 are also translated, thereby
opening or closing scissor mechanisms 420. Opening scissor
mechanisms 420 causes patient platform 70 of FIG. 1 to translate
vertically towards imager 504 closing scissor mechanisms 420 causes
patient platform 70 to translate vertically towards imager 50
translatable platform 40. Runners 435 are arranged inside channels
440 to keep beams 430 straight.
[0074] FIG. 5B illustrates an exemplary side view of scissor
mechanism 420, in a partially opened position, with patient
platform 70 at a top end thereof. The cut away sections of FIGS. 5A
and 5B are illustrated as well as a centering pin 490 described
above.
[0075] FIG. 5C illustrates en exemplary bottom view drawing of
patient platform 70 in accordance with a principle of the
invention, including scissor mechanism 420, beams 430, runners 435,
tubes 440, toothed linear members 450 and a tooth gear 455. Scissor
mechanism 420 are connected at the ends thereof to beams 430, and
beams 430 are connected at their ends to runners 435, which are
placed in channels 440. Beams 430 are also connected to a toothed
linear member 450. Toothed linear members 450 each mesh with tooth
gear 455.
[0076] The above has been illustrated in an embodiment in which a
pair of independent substantially orthogonal translation mechanisms
is provided, however this is not meant to be limiting in any way.
In another embodiment a rotation and extension mechanism is
provided, enabling translation to achieve a particular positioning
along the plane.
[0077] Vertical translation mechanism 60 has been described in
relation to a scissors mechanism, however this is not meant to be
limiting in any way. In particular, in another embodiment a
hydraulic mechanism is provided without exceeding the scope of the
invention.
[0078] FIG. 6 illustrates an exemplary high level side view of the
irradiation treatment apparatus and treatment arrangement of FIG. 1
with a seated patient secured in a generally vertical position
against patient support surface 90, with imager 50 in a neutral
position, in which the ultimate beam of irradiation is not
occluded.
[0079] FIG. 7 illustrates an exemplary high level side view of the
irradiation treatment apparatus and treatment arrangement of FIG. 1
with a standing patient secured in a generally vertical position
against patient support surface 90, with imager 50 in an imaging
position in accordance with a principle of the invention, in which
the ultimate beam of irradiation is occluded.
[0080] FIG. 8 illustrates an exemplary high level side view of an
irradiation treatment apparatus and treatment arrangement 600 in
which imager 610 exhibits a window 620 which when open allows for
entry of the fixed beam irradiation source. Imager 610 need not be
translated vertically. In one embodiment imager 601 is in a fixed
position. When window 620 is closed, imager 610 performs 360
degrees of imaging suitable for treatment planning and
inter-treatment verification. Preferably, when window 620 is open,
imager 610 is capable of performing lower resolution imaging
sufficient for intra-treatment verification.
[0081] FIG. 9A illustrates an exemplary high level top view of an
imager 700 exhibiting a radially shiftable section 710. When
radially shiftable section 710 is closed, imager 700 performs 360
degrees of imaging suitable for treatment planning and
inter-treatment verification. Preferably, when radially shiftable
section 710 is open, imager 700 is capable of performing lower
resolution imaging sufficient for intra-treatment verification
[0082] FIG. 9B illustrates an exemplary high level side view of an
irradiation treatment apparatus and treatment arrangement in which
imager 700 has shifted the radially shiftable section to allow for
entry of fixed beam irradiation source 10.
[0083] FIG. 10 illustrates an exemplary perspective drawing of an
embodiment of a patient support surface 90, exhibiting a knee
support surface 800; movable armpit and/or shoulder supports 810;
frontal securing mechanism 820; and foot support 830.
Advantageously, knee support surface 800 is foldable into a seat,
thereby enabling a sitting or standing presentation with a single
patient support surface 90.
[0084] FIG. 11 illustrates an exemplary high level flow chart of an
embodiment of a method of irradiation. In stage 1000, a patient is
secured in a generally vertical position to a patient support
surface. Optionally, the patient is secured in one of a standing
and a sitting position.
[0085] In one or more embodiments, stage 1010, the secured patient
is vertically translated to approximately align a target tissue
with the ultimate beam of a fixed beam irradiation source. In stage
1020, the secured patient is rotated, and optionally translated
along a horizontal plane, to a desired first irradiation angle and
presentation. It is to be understood that stage 1010 may be
accomplished intermingle with stage 1020, or after stage 1020,
without exceeding the scope of the invention.
[0086] In stage 1030, the imager, preferably a CT imager, is set to
a first mode occluding the treatment irradiation beam. In one
embodiment, the imager exhibits a fine resolution. In one
embodiment, the imager is translatable between two fixed positions,
and in another embodiment the imager is translatable over a range
of positions. The imager is thus substantially in-line with and
intersects, the ultimate beam from the fixed beam irradiation
source.
[0087] In another embodiment, as described above in relation to
FIG. 8, a window is closed. In yet another embodiment, as described
above in relation to FIGS. 9A-9B, a radially shiftable section is
closed.
[0088] In stage 1040, the patient target tissue is imaged at the
first irradiation angle presentation of stages 1010, 1020. In stage
1050, responsive to the imaging of 1050, the target tissue image is
viewed to determine if adjustment of the presentation is required.
This may be due to changes in the target tissue, or patient
registration misalignment.
[0089] In the event that adjustment is required, in stage 1060, the
secured patient is finely vertically translated, horizontally
translated along a horizontal plane and rotated to the desired
first irradiation angle and presentation responsive to the imaging
of stage 1050. Optionally, in stage 1070 imaging as described above
in relation to stage 1040 is again performed to confirm proper
presentation, and any further fine adjustment is further
performed.
[0090] In the event that in stage 1050 no adjustment was required,
or after stage 1070, in stage 1080 the imager is set to the second
mode in which the fixed beam irradiation source is not occluded. In
an embodiment in which the imager is translatable vertically, the
imager is translated to a neutral position. In the embodiment, as
described above in relation to FIG. 8, the window is opened. In yet
another embodiment, as described above in relation to FIGS. 9A-9B a
radially shiftable section is shifted to be open, i.e. no longer
presenting a closed ring.
[0091] In stage 1090, optionally the source of the fixed beam
irradiation is translated along the longitudinal axis of the
ultimate beam so as to exhibit the desired distance from the target
tissue. In another embodiment a nominal position is utilized and
the energy level of irradiation is instead modified.
[0092] In stage 1100, the patient is irradiated from the fixed beam
irradiation source at the first irradiation angle. Optionally, if
allowed by the imager in the second mode, such as imager 610 of
FIG. 8 and imager 700 of FIGS. 9A, 9B, intra-treatment imaging is
accomplished, typically at a lower resolution than the imaging of
stage 1040. It is to be understood that preferably the patient
position and presentation remains unchanged between the confirming
imaging of stages 1040, 1070 and the irradiation of stage 1100.
[0093] In the event that multiple irradiation angles and
presentations have been prescribed, in stage 1110, the secured
patient is rotated about the z-axis as shown in FIG. 1, and
optionally translated at least partially along a horizontal plane
to a desired second irradiation angle and presentation. Optionally,
the secured patient may be further vertically translated as
required. In stage 1120, the imager of stage 1030 is set to the
first mode. The imager is thus substantially in-line with, and
generally occludes, the ultimate beam from the fixed beam
irradiation source.
[0094] In stage 1130, the patient target tissue is imaged at the
second irradiation angle presentation of stage 1110. Adjustment
responsive to the imaging, as described above in relation to stages
1050-1070, may be accomplished if required.
[0095] In stage 1140 the imager is set to the second mode in which
the beam is not occluded, i.e. no longer in-line with the fixed
beam irradiation source. In stage 1150, optionally the source of
the fixed beam irradiation is translated along the longitudinal
axis of the ultimate beam so as to exhibit the desired distance
from the target tissue.
[0096] In stage 1160, the patient is irradiated from the fixed beam
irradiation source at the second irradiation angle. It is to be
understood that preferably the patient position and presentation
remains substantially unchanged between the confirming imaging of
stage 1130 and the irradiation of stage 1160.
[0097] The above has been described in an embodiment in which 1 or
2 irradiation angles and presentations are prescribed, however this
is not meant to be limiting in any way. In another embodiment, 3 or
more irradiation angles and presentations are prescribed by
repeating stages 1110-1160 for each additional angle and
presentation.
[0098] FIG. 12 illustrates an exemplary high level flow chart of an
embodiment of a method of treatment planning. In stage 2000, a
patient is secured in a generally vertical position to a patient
support surface. Optionally, the patient is secured in one of a
standing and a sitting position.
[0099] In stage 2010, the imager, preferably a CT imager, is set to
a first mode. Preferably, the imager exhibits a fine resolution. In
one embodiment the imager is translatable between two fixed
positions, and in another embodiment the imager is translatable
over a range of positions.
[0100] In another embodiment, as described above in relation to
FIG. 8, a window is closed. In yet another embodiment, as described
above in relation to FIGS. 9A-9B a radially shiftable section is
closed.
[0101] In stage 2020, the secured patient of stage 2000 is
translated vertically through the imager of stage 2010 so as to
image a slice of the patient. In stage 2030, the image of stage
2020 is used as part of a treatment planning process to determine
irradiation angle power and distance.
[0102] FIG. 13 illustrates an exemplary high level frontal view
drawing of a second embodiment of an irradiation treatment
apparatus and treatment arrangement. In some instances, the
embodiment of FIG. 13 differs from irradiation treatment apparatus
5 of FIG. 1, primarily in the order of the translation and rotation
mechanism. FIG. 13 includes a translation and rotation mechanism
900 constituted of a rotation mechanism 910, a first translation
mechanism 920, a second translation mechanism 930 and a platform
935; a patient support surface 90; a vertical translation mechanism
940; and a fixed beam irradiation source 10. Rotation mechanism 910
is in communication with a horizontal base, such as a floor or a
platform first translation mechanism 920 is in communication with
rotation mechanism 910, and second translation mechanism 930 is in
communication with first translation mechanism 920. Platform 935 is
in communication with second translation mechanism 930, and via
vertical translation mechanism 940 with patient support surface 90.
First translation mechanism 920 is arranged to translate along a
direction denoted Y, orthogonal to the direction of translation of
second translation mechanism 930, whose direction is denoted X.
Directions X and Y generally define a plane orthogonal to the axis
of rotation of rotation mechanism 910, illustrated as rotation
Z.sub.i. The direction of motion of vertical translation mechanism
940 is denoted Z.
[0103] Advantageously, the arrangement of FIG. 13 allows for
setting the isocenter of a target tissue to be aligned with the
output beam from fixed beam irradiation source 10, and to be
rotated about an axis Z generally along the isocenter of the target
tissue.
[0104] The above has been described in an embodiment in which
patient support surface 90 is generally vertical, however this is
not meant to be limiting in any way. Patient support surface 90 may
in one embodiment enable a tilt of up to 15.degree. from vertical
without exceeding the scope of the invention. In another
embodiment, patient support surface 90 is generally vertical;
however a separate tilting head support is provided allowing for
tilting of the head while maintaining the patient body in a
generally upright position.
[0105] Thus, the present embodiments enable an irradiation
treatment apparatus comprising a patient securing means arranged to
secure a patient in generally vertical position to a patient
support surface. The patient support surface is connected at one
end to a rotation and translation platform, arranged to rotate the
patient support surface about a generally vertical axis thereof and
to translate the patient support surface along a plane
perpendicular to the axis of rotation. The patient support surface
is further translatable vertically, generally along the axis of
rotation. An imager, preferably a computerized tomography imager
exhibiting fine resolution and a large scan width is provided and
arranged to exhibit two modes: a first mode in which the beam of
irradiation is occluded and a second mode in which the beam if
irradiation is not occluded.
[0106] It is appreciated that certain features of the invention,
which are, for clarity, described in the context of separate
embodiments, may also be provided in combination in a single
embodiment. Conversely, various features of the invention which
are, for brevity, described in the context of a single embodiment,
may also be provided separately or in any suitable
sub-combination.
[0107] The terms "include", "comprise" and "have" and their
conjugates as used herein mean "including but not necessarily
limited to".
[0108] It will be appreciated by persons skilled in the art that
the present invention is not limited to what has been particularly
shown and described hereinabove. Rather the scope of the present
invention is defined by the appended claims and includes both
combinations and sub-combinations of the various features described
hereinabove as well as variations and modifications thereof which
would occur to persons skilled in the art upon reading the
foregoing description.
* * * * *